This study aimed to compare hospital and long-term clinical outcomes associated with various treatment methods for Stanford A type aortic intramural hematoma (IMH) to provide a reference for clinical decision-… Read More
Category: General
Comparison of surgical and conservative treatment outcomes for type a aortic intramural hematoma
This study aimed to compare hospital and long-term clinical outcomes associated with various treatment methods for Stanford A type aortic intramural hematoma (IMH) to provide a reference for clinical decision-… Read More
Operative treatment of pulmonary primitive neuroectodermal tumor: a case report and literature review
Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date, fewer than 30 cases of pulmonary PNET h… Read More
Mid-term results following pulmonary artery patch augmentation in congenital heart disease
Transl Pediatr. 2023 Nov 28;12(11):1992-2000. doi: 10.21037/tp-23-382. Epub 2023 Nov 24.
ABSTRACT
BACKGROUND: Treatment of pulmonary artery (PA) stenosis in congenital heart disease is associated with adverse outcomes. The aim of this retrospective cohort study was to compare outcomes after surgical patch augmentation of PA stenosis in patients with biventricular congenital heart disease using different patch materials.
METHODS: We identified all patients from our institutional congenital heart disease database who underwent patch augmentation for PA stenosis on the main pulmonary artery (MPA) or PA branches between 2012 and 2018. Patch materials used were glutaraldehyde fixated autologous pericardium (AP), expanded polytetrafluoroethylene (ePTFE), equine pericardium (EP), and bovine pericardium (BP). The primary study endpoint was the composite of catheter-based re-intervention or re-operation to relieve recurrent stenosis at the site of prior implanted patch material.
RESULTS: A total of 156 patients (median age, 5 months, range, 0-85 months; median weight, 6.2 kg, range, 2.8-15.0 kg) underwent patch augmentation using 163 patches (ePTFE =99, 61%; EP =34, 21%; AP =25, 15%; BP =5, 3%). Overall, 131 (84%) patients underwent patch augmentation at the MPA, and 25 (16%) patients underwent patch augmentation at one or both PA branches. Over a mean follow-up period of 4±2 years, 30 patients (19%) reached the study endpoint. Freedom from primary endpoint was 92%±3% for the MPA and 25%±9% for PA branches at 5 years, respectively (P<0.001). Comparison of patch materials revealed similar re-intervention rates between ePTFE, AP, and EP. In contrast, outcomes were significantly decreased following the usage of BP when compared to other materials (ePTFE vs. BP, P=0.01; EP vs. BP, P=0.005). In the multivariable analysis, lower weight at index operation, patch augmentation of PA branches, and usage of BP were independently associated with re-intervention.
CONCLUSIONS: Patch augmentation of the MPA was associated with acceptable outcomes, while patch augmentation of PA branch stenosis remained independently associated with re-intervention. None of the used patch materials demonstrated superiority; however, BP had a higher rate of re-interventions.
PMID:38130592 | PMC:PMC10730962 | DOI:10.21037/tp-23-382
MSCT study for adult esophageal diverticulum with secondary broncho-esophageal fistula
Broncho-esophageal fistula (BEF) secondary to esophageal diverticulum is a rare clinical condition, which is often misdiagnosed for a long time. The aim of our study is to summarize and clarify the advantages … Read More
MSCT study for adult esophageal diverticulum with secondary broncho-esophageal fistula
Broncho-esophageal fistula (BEF) secondary to esophageal diverticulum is a rare clinical condition, which is often misdiagnosed for a long time. The aim of our study is to summarize and clarify the advantages … Read More
Simultaneous Identification of Unroofed Coronary Sinus Atrial Septal Defect and Atrial Septal Defect Secundum Using Cardiac Computed Tomography Angiography
Cureus. 2024 Jan 19;16(1):e52575. doi: 10.7759/cureus.52575. eCollection 2024 Jan.
ABSTRACT
Unroofed coronary sinus (UCS) represents a rare subtype of atrial septal defect (ASD), an adult congenital heart disease characterized by communication between the systemic and pulmonary circulations at the atrial level. This case report presents the unique occurrence of a large, unrepaired ASD secundum and an incidentally identified UCS type II in a 25-year-old female during a cardiac murmur assessment. The diagnosis of ASD secundum was initially made using transthoracic echocardiography (TTE) and was later confirmed with a transesophageal echocardiogram. The identification of the UCS was achieved through the utilization of cardiac computed tomography angiography (CCTA). Ultimately, the patient underwent a successful reroofing procedure using a bovine pericardial patch.
PMID:38370993 | PMC:PMC10874617 | DOI:10.7759/cureus.52575
Resection of hypertrophic papillary muscles and mitral valve replacement in a patient with midventricular hypertrophic obstructive cardiomyopathy – a new approach
Midventricular hypertrophic obstructive cardiomyopathy (HOCM) is characterized by hypertrophy of the interventricular septum (IVS) and – in rare cases – of the papillary muscles (PM), which subsequently can ca… Read More
Viscoelastic Properties of Acellular Matrices of Porcine Esophageal Mucosa and Comparison with Acellular Matrices of Porcine Small Intestine Submucosa and Bovine Pericardium
Materials (Basel). 2023 Dec 27;17(1):134. doi: 10.3390/ma17010134.
ABSTRACT
The aim of this study was to compare the viscoelastic properties of a decellularized mesh from the porcine esophagus, prepared by our group, with two commercial acellular tissues derived from porcine small intestine submucosa and bovine pericardium for use in medical devices. The tissues’ viscoelastic properties were characterized by creep tests in tension, applying the load in the direction of the fibers or the transverse direction, and also by dynamic-shear mechanical tests between parallel plates or in tension at frequencies between 0.1 and 35 Hz. All the tests were performed in triplicate at a constant temperature of 37 °C immersed in distilled water. The tissues’ surface and cross-sectional microstructure were observed by scanning electron microscopy (SEM) to characterize the orientation of the fibers. The matrices of the porcine esophagus present an elastic modulus in the order of 60 MPa when loaded in the longitudinal direction while those of the porcine intestine submucosa and bovine pericardium have an elastic modulus below 5 MPa. Nevertheless, the shear modulus of bovine pericardium nearly triplicates that of the esophageal matrix. The viscoelasticity of decellularized esophageal mucosa is characterized by a fast change in the creep compliance with time. The slope of the creep curve in the double logarithmic plot is twice that of the control samples. These results are consistent with the microstructure observed under electron microscopy regarding the orientation of the fibers that make up the matrices.
PMID:38203987 | PMC:PMC10779732 | DOI:10.3390/ma17010134
Image fusion guidance for left subclavian artery in situ fenestration during thoracic endovascular repair
To evaluate the feasibility and clinical benefit of utilizing image fusion for thoracic endovascular repair (TEVAR) with in situ fenestration (ISF-TEVAR).